Provider Demographics
NPI:1902833569
Name:ZACHAR, LENKA (MD)
Entity Type:Individual
Prefix:
First Name:LENKA
Middle Name:
Last Name:ZACHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 MARGARET ST STE 302-186
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-3868
Mailing Address - Country:US
Mailing Address - Phone:904-308-5266
Mailing Address - Fax:904-308-5267
Practice Address - Street 1:3 SHIRCLIFF WAY STE 520
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4777
Practice Address - Country:US
Practice Address - Phone:904-308-5266
Practice Address - Fax:904-308-5267
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME684972083P0011X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31925AMedicare ID - Type Unspecified
FL31925OtherBC BS OF FLORIDA
FLBZ3811331OtherDEA NUMBER
FL250256900Medicaid
FL020048246OtherRAILROAD MEDICARE NUMBER